TY - JOUR
T1 - MRI predictive score of pial vascularization of supratentorial intracranial meningioma
AU - Friconnet, Guillaume
AU - Espíndola Ala, Victor Hugo
AU - Janot, Kevin
AU - Brinjikji, Waleed
AU - Bogey, Clément
AU - Lemnos, Leslie
AU - Salle, Henri
AU - Saleme, Suzana
AU - Mounayer, Charbel
AU - Rouchaud, Aymeric
N1 - Publisher Copyright:
© 2019, European Society of Radiology.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Objective: Meningiomas are highly vascularized tumors which may recruit pial blood supply. Pial supply complicates tumor treatment in numerous ways. The objective of this study was to establish a reliable MRI-based diagnostic score to predict the existence of pial blood supply in supratentorial intracranial meningiomas and then correlate the score with clinical and surgical outcomes and histopathological findings. Methods: We performed a retrospective analysis of supratentorial histologically proven meningiomas in our institution from 2010 to 2018. A score was built based on MRI criteria and correlated with digital subtraction angiography (DSA) pial vascularization assessment. The score was then validated on a second independent population recruited with the same modalities. Results: Logistic regression identified four parameters related to pial blood supply which were used to build the score: skull base location, tumor size > 45 mm, peritumoral flow voids, and incomplete cerebrospinal fluid rim. The overall diagnostic performance in predicting pial blood supply was as follows: sensitivity 97.8%, specificity 76.9%, predictive positive value 88.2%, negative predictive value 95.2%, and accuracy 90.3%. Inter-reader agreement and Cohen’s kappa were good, respectively, of 90.7% and 0.69. A high score was associated with aggressive meningioma (World Health Organization II–III) (p = 0.04) and with greater importance of pial supply relative to dural supply. Conclusions: We have identified a reliable way to use MRI to predict the existence of pial blood supply in supratentorial intracranial meningiomas. A higher score also predicted higher grade meningioma. Key Points: • Accurate and reproducible MRI score composed of four items to predict the existence of pial blood supply in supratentorial meningioma. • High score is associated with high-grade meningioma (WHO II–III) but also with greater importance of pial supply relative to dural supply.
AB - Objective: Meningiomas are highly vascularized tumors which may recruit pial blood supply. Pial supply complicates tumor treatment in numerous ways. The objective of this study was to establish a reliable MRI-based diagnostic score to predict the existence of pial blood supply in supratentorial intracranial meningiomas and then correlate the score with clinical and surgical outcomes and histopathological findings. Methods: We performed a retrospective analysis of supratentorial histologically proven meningiomas in our institution from 2010 to 2018. A score was built based on MRI criteria and correlated with digital subtraction angiography (DSA) pial vascularization assessment. The score was then validated on a second independent population recruited with the same modalities. Results: Logistic regression identified four parameters related to pial blood supply which were used to build the score: skull base location, tumor size > 45 mm, peritumoral flow voids, and incomplete cerebrospinal fluid rim. The overall diagnostic performance in predicting pial blood supply was as follows: sensitivity 97.8%, specificity 76.9%, predictive positive value 88.2%, negative predictive value 95.2%, and accuracy 90.3%. Inter-reader agreement and Cohen’s kappa were good, respectively, of 90.7% and 0.69. A high score was associated with aggressive meningioma (World Health Organization II–III) (p = 0.04) and with greater importance of pial supply relative to dural supply. Conclusions: We have identified a reliable way to use MRI to predict the existence of pial blood supply in supratentorial intracranial meningiomas. A higher score also predicted higher grade meningioma. Key Points: • Accurate and reproducible MRI score composed of four items to predict the existence of pial blood supply in supratentorial meningioma. • High score is associated with high-grade meningioma (WHO II–III) but also with greater importance of pial supply relative to dural supply.
KW - Magnetic resonance imaging
KW - Meningioma
KW - Retrospective studies
KW - Supratentorial neoplasms
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U2 - 10.1007/s00330-019-06197-6
DO - 10.1007/s00330-019-06197-6
M3 - Article
C2 - 30963273
AN - SCOPUS:85064278200
SN - 0938-7994
VL - 29
SP - 3516
EP - 3522
JO - European radiology
JF - European radiology
IS - 7
ER -